ANNUAL DEM CHECKS

Q: This question is for Dr. Heltemes. First, great presentation!Many dermatologists (at least mine!!) recommend annual dermatology screenings. Given the genesis and progression of melanoma, do you feel annual dem screenings are still advisable? Or can then they reasonably be stretched out to 24 months? Thanks! Eric H

A: Hello Eric – Glad you were able to listen in! The issue of skin cancer screening is not very well settled, other than for those at increased risk of melanoma. Most organizations do not recommend routine skin exams in those of average melanoma risk simply because it has not been shown with any degree of certainty that it saves lives. But intuitively, it makes complete sense that it might be of use and that the risks of doing so are minimal (other than increased health care costs!).

Those with any increased risk certainly warrant routine exams, with the frequency determined by the degree of increased risk. And one could argue too that being a white male >age 50 is an increased risk. Also any screening exam is likely better by a dermatologist than by a primary care doc.

As for one vs two years, I don’t know of any good comparison. There was a screening trial in Germany that went with two year follow-ups and did not find any reduction in melanoma deaths, but it was only 5 years of f/u and was probably underpowered.

Self-examination may be the most effective strategy – maybe that in conjunction with two year derm screening would be a practical approach?! Best wishes to you, Brad

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